| NPI | 1417261199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35.132051) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301096100) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2018-02-23 |